From the case:
Gallbladder empyema
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The gallbladder is distended and full of low-density fluid. The gallbladder wall appears to enhance normally with some areas of thickening. No visible gallstones. Periportal edema, but no ductal dilatation.
Case Discussion
Gallbladder empyema in a patient with recurrent presentations with right upper abdominal pain with numerous ultrasound scans showing sludge and no stones.
On this occasion, she presented with swinging pyrexia. The tense gallbladder was drained percutaneously.